Often coined the ‘sun mustache’ or ‘pregnancy mask’, melasma is a common skin pigmentation disorder that can appear in various ways.
While melasma is harmless, these dark patches can be frustrating to live with – something cosmetic dermatologist Dr Sam Bunting understands from her Marylebone clinic. She explains more patients are coming to see her for hyperpigmentation than ever before. “Women (and men) are starting to grasp that an uneven skin tone can be terribly ageing. Lines and wrinkles matter less when the skin reflects the light and is a clean, bright canvas – which doesn’t happen when there are light-absorbing splodges everywhere.” Ageing aside, it can also mean an entire make-up rethink in terms of products and application technique.
Right now the commonest pigmentation disorder Dr Bunting treats is melasma, which can appear on the cheekbones, the forehead and upper lip in people of all ethnicities. The cause? “Sun is an important trigger,” she says, and aesthetic doctor Barbara Kubicka concurs. She points out that melasma can be more common in darker skin tones, because of sun exposure as much as genetic predisposition. “As darker skin contains more pigment (or more active pigment), issues including melasma can be more common, but those with darker skin types very rarely use sun protection, believing that as their skin doesn’t burn they don’t need to use it”.
Secondly, the condition “is often offset by a hormonal change like starting the oral contraceptive pill, pregnancy or even HRT,” Dr Bunting adds – further explaining melasma’s nicknames. In this case, “if a new medication is the provoking influence, stopping it can resolve melasma, but alas not always.”
In fact, melasma rarely resolves itself and is notoriously tricky to treat.

Peels and lasers
Many skincare professionals swear by chemical peels and laser skin lightening to treat melasma.
Esteemed London ‘super facialist’ Teresa Tarmey says the Cosmelan Depigmentation Peel “is hands down the best way to treat melasma in-clinic and then with at home maintenance”.
This chemical treatment uses azelaic acid and kolic acid in favour of hydroquinone. With a Cosmelan treatment Tarmey says to expect “a slight burning and tightening of the skin and if your skin is sensitive, you might also notice some itchiness, but a hydrating cream will make things more comfortable.” There is some ‘downtime’, in that you will notice significant skin shedding as the peel speeds up the cell turnover process. Dr Kubicka also performs this treatment, and says that this type of combination peel is effective yet safe for all skin types.